Following the recent decision in March to classify Tokyo Metropolitan Hiroo Hospital as a "medical institution that accepts international patients," the Mainichi Shimbun decided to interview the institution's medical coordinator for international patients at the hospital, 44-year-old Mayumi Okauchi.

With approximately 3,000 new international patients at the hospital being recorded since data collection there began in October 2015, the hospital decided to assign Okauchi as a linguistic intermediary between hospital staff and international patients. With its welcoming and flexible approach to patients who do not speak that much Japanese and who have different cultural and religious backgrounds, the hospital's efforts have been recognized by the Japan Medical Service Accreditation for International Patients (JMIP), which is reflected by JMIP accrediting the hospital as a "medical institution that accepts international patients," last month. With all this in mind, the Mainichi Shimbun took the decision to interview Okauchi -- the answers to which are shown below.

Question: Can you tell us about your job?

Answer: I'm responsible for assigning medical interpreting tasks to other interpreters at the hospital while doing interpretation myself as well, and thinking about ways to improve our services for international patients. I also check and edit manuals written in English concerning medical tests and hospitalization.

Q: Why did you become a medical interpreter and coordinator for international patients?

A: In the past, I did some Japanese-English interpreting at a clinic in the U.S. after obtaining my Japanese and American nursing licenses. Upon returning to Japan, I joined Hiroo Hospital and was assigned to the emergency room, which has a lot of international patients. I instinctively began to liaise with these patients in English, in a very natural manner. Subsequently, the hospital has employed other medical interpreters, who I supervise.

Q: Can you tell us about the interpreting service at Hiroo Hospital?

A: Eighty percent of the international patients at our hospital use English when conversing with the medical team here. There are some non-native English speakers, but often these patients have an excellent grasp of English, and use English at work at places such as nearby embassies. About 10 to 20 percent of the patients speak Chinese. Therefore, there are three Japanese-English interpreters in our team, including myself, in addition to two Japanese-Chinese interpreters.

Q: It must be challenging when trying to communicate with patients who speak languages other than English and Chinese?

A: In order to respond to patients who do not speak English or Chinese, and to handle patients during the middle of the night, we offer a special video telephone service that offers external language support in five different languages. We also have about 100 "support members" who can speak some Korean, French, German and Portuguese. The system can also differentiate between "conversational level" and "easy medical term level." We also use a special 12-language guide that is aimed toward medical institutions. The total number of languages spoken by patients at our hospital exceeds 100, so we also need to be flexible, by using tools such as the internet, in order to provide a timely service.

Q: Is awareness and understanding about your language support service spreading within the hospital?

A: Since receiving the JMIP accreditation, we have shared a manual within our hospital about how to respond to international patients. Previously, each department and ward would try to break down the language barrier somehow but now we have a robust medical interpreting system that enables staff to call on our services. As awareness about this system increases, we are being called on more and more.

Q: Why is medical interpreting important?

A: In one case, a Japanese conversation was going on between the doctor in charge and a person accompanying an international patient, and I was then asked by the patient to interpret. Even if a patient appears to be complaining, the patient can converse smoothly with the medical staff if I enter into the middle and make the staff understand that the patient is just talking vehemently. If an interpreter is involved in a conversation between a patient and medical staff, the interpreter will try to fully translate what the medical staff says so that the patient can understand even technical matters. Otherwise, the patient, who has the right to know, would be left behind in the conversation. In the U.S., I experienced discrimination and other such problems as a foreigner, so I don't want our patients to have to go through the same experience. With this in mind, I try my best to understand and accept the patients, who may have different sets of cultural values.